AMN Healthcare Services, Inc. Common Stock Certificate

Summary

This document certifies that the named holder owns fully paid shares of common stock in AMN Healthcare Services, Inc., a Delaware corporation. The shares are transferable by the holder or their authorized agent upon proper endorsement and surrender of the certificate. The certificate must be countersigned by the transfer agent to be valid. The corporation will provide details about stock rights and preferences to shareholders upon request. The certificate also includes instructions for transferring ownership and requires signature guarantees for assignments.

EX-4.1 3 y51181a2ex4-1.txt EXHIBIT 4.1 1 EXHIBIT 4.1 AMN HEALTHCARE NUMBER SERVICES, INC. AMN SHARES COMMON STOCK COMMON STOCK SEE REVERSE FOR CERTAIN DEFINITIONS CUSIP 001744 10 1 Incorporated Under the Laws of the State of Delaware THIS CERTIFIES THAT IS THE RECORD HOLDER OF FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK, $0.01 PAR VALUE PER SHARE, OF A.M.N. Healthcare Services, Inc. (hereinafter called the "Corporation"), transferable on the books of the Corporation by the registered holder hereof in person or by duly authorized attorney upon surrender of this Certificate properly endorsed. This Certificate is not valid until countersigned and registered by the Transfer Agent and Registrar. In Witness Whereof, the Corporation has caused the facsimile signatures of its duly authorized officers and its facsimile seal to be affixed hereto. DATED: [AMN HEALTHCARE SERVICES, INC. CORPORATE SEAL] /s/Steven C. Francis /s/Susan B. Nowakowski PRESIDENT AND CHIEF EXECUTIVE OFFICER SECRETARY AND CHIEF OPERATING OFFICER Countersigned and Registered: Transfer Agent and Registrar, AMERICAN STOCK TRANSFER & TRUST COMPANY (NEW YORK, NY) By: Authorized Signature 2 AMN HEALTHCARE SERVICES, INC. This Corporation will furnish without charge to each stockholder who so requests, a copy of the designations, powers, preferences and relative, participating, optional or other special rights of each class of stock or series thereof and the qualifications, limitations or restrictions of such preferences and / or rights. Any such requests may be addressed to the Secretary of the Corporation. The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations: TEN COM - as tenants in common TEN ENT - as tenants by the entireties IT TEN - as joint tenants with right of survivorship and not as tenants in common UNIF GIFT MIN ACT - __________ Custodian _________ (Cust) (Minor) under Uniform Gifts to Minors Act __________________________ (State) UNIF TRP MIN ACT - __________ Custodian (until age _______) (Cust) ________________ under Uniform Transfers (Minor) to Minors Act __________________________ (State) Additional abbreviations may also be used though not in the above list. For Value received, ______________________ hereby sell, assign and transfer unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE [ ] [ ] ________________________________________________________________________________ PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE ________________________________________________________________________________ ________________________________________________________________________________ _________________________________________________________________________ Shares of the Stock represented by the within Certificate, and do(es) hereby irrevocably constitute and appoint _____________________________________________ ________________________ Attorney to transfer the sold Stock on the books of the within named Corporation with full power of substitution in the premises. Dated __________________________ X ______________________________________ X ______________________________________ NOTICE: THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER. Signature(s) Guaranteed: By _____________________________________________________________________________ THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15.